Document Detail

Pediatric cervicofacial necrotizing fasciitis: a case report and review of a 10-year national pediatric database.
MedLine Citation:
PMID:  22508620     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To present a case of a pediatric cervicofacial necrotizing fasciitis (NF), a rapidly progressive infection, and a review of a 10-year pediatric inpatient database.
DESIGN: Case report and review.
SETTING: Pediatric intensive care unit.
PATIENTS: A healthy 5-year-old male who developed NF of the lower lip 36 hours following minor trauma. International Classification of Diseases, Ninth Revision, code 728.86 (NF), was the inclusion criteria for the Kids' Inpatient Database (KID) in 1997 and 2006.
RESULTS: A pediatric case is presented with a thorough photographic record demonstrating the need for rapid diagnosis and treatment. In a review of the KID from 1997 and 2006, the relative risk of being discharged with NF in 2006 vs 1997 was 1.4 (95% CI, 9.95-2.28). Age at diagnosis of NF was older in 2006 compared with 1997 (11.5 years vs 8.05 years; P < .001). Deaths with a diagnosis of NF increased from 1997 compared with 2006: from 3.9% to 5.4%. In 2006, the odds of death were 15.1 times higher in pediatric discharges with a diagnosis of NF compared with discharges without a diagnosis of NF (P < .001; 95% CI, 9.3-23.1).
CONCLUSIONS: Even with the advent of new treatments and antibiotics, the incidence and death rates of NF have changed little over the past 10 years. While it is still a rare diagnosis, knowledge and awareness of necrotizing fasciitis with aggressive medical and surgical treatment are still the foundation in disease survival.
Ericka King; Robert Chun; Cecille Sulman
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  138     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-17     Completed Date:  2012-06-04     Revised Date:  2014-01-13    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-5     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Child, Preschool
Combined Modality Therapy
Databases, Factual
Fasciitis, Necrotizing / diagnosis*,  microbiology,  mortality,  therapy*
Hyperbaric Oxygenation
Lip / injuries*
Lip Diseases / diagnosis*,  microbiology,  mortality,  therapy*
Reconstructive Surgical Procedures
United States / epidemiology
Wisconsin / epidemiology
Grant Support
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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